Transvaginal sonography, sonohysterography, and hysteroscopy for investigation of focal intrauterine lesions in women with recurrent postmenopausal bleeding after dilatation & curettage.
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| Abstract | PURPOSE: To determine the diagnostic accuracy of different diagnostic methods (blind dilatation & curettage (D&C), transvaginal ultrasonography (TVS), sonohysterography (SH), and hysteroscopy) compared with gold standard (hysteroscopic biopsy's histopathologic result) in diagnosis of focal intrauterine lesions of recurrent postmenopausal bleeding. METHODS: 36 postmenopausal women with recurrent vaginal bleeding after a normal D&C results were enrolled into the study. TVS, SH, hysteroscopy were performed on all patients. Outcomes of blind D&C, TVS, SH, and hysteroscopy were compared with results of gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LR) were calculated. RESULTS: Blind D&C sensitivity, specificity, PPV, and NPV were 47, 68, 57, 59%, respectively in comparison with gold standard. Blind D&C fails to diagnose 70% of all focal intracavitary lesions. TVS sensitivity, specificity, PPV, NPV were 63, 78, 89, 41%, respectively. SH yielded better results; with 93% sensitivity, 56% specificity, 86% PPV, and 71% NPV. Hysteroscopy sensitivity, specificity, PPV, and NPV were 100, 44, 84, 100%, respectively. CONCLUSIONS: In experienced hands, SH can be an initial evaluation method of uterine cavity for detecting focal lesions in women with recurrent postmenopausal bleeding.
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| Authors | A Yasemin Karageyim Karsidag, Esra Esim Buyukbayrak, Bulent Kars, Orhan Unal, M Cem Turan |
| Journal | Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 281 Issue 4 Pg. 637-43 (Apr 2010) ISSN: 1432-0711 [Electronic] Germany |
| PMID | 19533157 (Publication Type: Journal Article) |
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